Comparison of surgical and endovascular treatments for fusiform intracranial aneurysms: systematic review and individual patient data meta-analysis

Telles, João Paulo Mota; Solla, Davi Jorge Fontoura; Yamaki, Vítor Nagai; Rabelo, Ní­collas Nunes; Silva, Saul Almeida da; Caldas, José Guilherme Pereira; Teixeira, Manoel Jacobsen; Rosí, Jefferson; Figueiredo, Eberval Gadelha

doi:10.1007/s10143-020-01440-x

Cited by 8 publications

(1 citation statement)

References 49 publications

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“…Both surgery and EVT have proven to be successful (94). In the report of Barletta et al, 77% of surgical procedures presented good outcomes, 91.5% of reconstructive EVTs presented a good outcome, and 79.6% of deconstructive EVTs presented a good outcome (95).…”

Section: Prognosismentioning

confidence: 99%

Intracranial Fusiform and Circumferential Aneurysms of the Main Trunk: Therapeutic Dilemmas and Prospects

et al. 2021

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Intracranial fusiform and circumferential aneurysms (IFCAs), especially those located on the main trunk, are uncommon and difficult to manage. Currently, literature focused on IFCAs on the main trunk of cerebral arteries is lacking. The treatment of IFCAs is still under debate. Therefore, in this review, we further explore the treatment of this complicated entity. In addition, we also present some interesting cases. Based on the literature review and our experience, we found that IFCAs are often located in the vertebrobasilar system and that ruptured or large symptomatic IFCAs are associated with increased mortality and higher rebleeding rates. The treatment strategies for IFCAs can be classified as deconstructive and reconstructive methods via open surgery and/or endovascular treatment (EVT). Currently, EVT is a popular method and the main therapeutic choice. In particular, flow diversion has revolutionized the treatment of IFCAs. Parent artery occlusion (PAO) with or without revascularization may still be considered a suitable choice. Complex IFCAs that cannot be resolved by EVT can also be treated via open surgery with or without extracranial–intracranial bypass. Targeted embolization for the weak points of IFCAs is a temporary or palliative choice that is rarely used. In summary, despite complications, both surgical treatment and EVT are effective options for appropriately selected cases. Due to the development of endovascular implants, EVT will have better prospects in the future.

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Section: Prognosismentioning

confidence: 99%